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Pleural effusion exudate

S Li, H Huang, K Xu, Z J Xu
Objective: To describe the clinical characteristics of respiratory manifestations of yellow nail syndrome. Methods: We conducted a retrospective analysis of 2 patients with respiratory diseases associated with yellow nail syndrome. Their clinical and chest radiological data were collected. We searched PubMed, Wanfang and CNKI databases with the keywords "yellow nail syndrome, yellow nail and lung" in Chinese and English. And the relevant literatures, including 6 articles in Chinese and 81 articles in English, were reviewed...
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
James A Stefater, Dean Eliott, Leo A Kim
Purpose: To describe a case of a patient with acute systemic lupus erythematous (SLE) causing choroidal effusions and to report a novel technique for evaluation of the choroidal fluid which sheds light on effusion pathogenesis. Observations: A 37 year-old woman was referred for decreased vision, eye pain and shortness of breath. The patient had bilateral angle closure glaucoma from choroidal effusions and bilateral pleural effusions. Work-up revealed new onset acute SLE...
April 2017: American Journal of Ophthalmology Case Reports
Silvia Bielsa, Alberto García-Zamalloa, Paula Monteagudo, Didac González-Sans, David Ascanio, Aureli Esquerda, Jorge Taboada-Gómez, José M Porcel
OBJECTIVE: To assess whether changes in pleural fluid (PF) biochemistries between two consecutive thoracenteses enable clinicians to predict malignant or benign pleural effusions (PE). METHODS: Retrospective study of patients with lymphocytic exudates and negative PF cytology, who underwent a second thoracentesis in our center in the last 15 years in whom a final diagnosis was reached (derivation sample). Absolute (Δa) and percentage differences (Δp) in PF biochemistries which predicted a malignant or benign PE in the derivation sample were evaluated in an independent population (validation sample)...
February 26, 2018: Archivos de Bronconeumología
N Bayram, Y Karakan, M Uyar, B Ozyurt, A Filiz
INTRODUCTION: Pleural effusion is a common clinical problem with management difficulties. The aim of this study is to evaluate vascular endothelial growth factor (VEGF) in differential diagnosis of pleural effusions and the presence of correlation between radiological features and biochemical properties. MATERIALS AND METHODS: The study included patients with pleural effusion. VEGF levels in the pleural fluid were measured by enzyme-linked immunosorbent assay. RESULTS: A total of 97 patients who had exudative pleural effusion related to lung cancer (n = 17), nonpulmonary malignancies (n = 25), mesothelioma (n = 9), pneumonia (n = 14), tuberculosis (n = 8), miscellaneous causes (n = 6), and transudative effusion (n = 18) were included...
January 2018: Nigerian Journal of Clinical Practice
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: To develop a Clinical Prediction Rule (CPR) for diagnosis of Pleural Tuberculosis (PT) in patients with pleural exudates in Peru. METHODS: We obtained clinical and laboratory information in patients attending 2 reference hospitals in Lima, Peru with exudative pleural effusion. Predictive findings associated with pleural tuberculosis in a multiple logistic regression model were used to develop the CPR. Definite diagnosis of PT was based on a composite reference standard including bacteriologic and/or histologic analysis of pleural fluid and pleural biopsy specimens...
February 2, 2018: International Journal of Infectious Diseases: IJID
Tomoo Inoue, Atsushi Shimomura, Takuji Sugimoto, Shiori Wakamiya, Ukou Chou, Akira Fujiwara, Fumihiro Uchikoshi, Tarou Watanabe, Natsuko Kitamura
This study reports the treatment and local control of advanced breast cancer with a giant ulcer. A 53-year-old woman presented with a large left breast tumor and an associated giant ulcer, with massive exudates, bleeding, and an offensive odor. Histopathological examination revealed an invasive ductal carcinoma(Luminal B type). Computed tomography(CT) showed multiple metastases to the lymph nodes, lungs, liver and bones. The patient received chemotherapy with a combina- tion of paclitaxel(PTX 90mg/m / 2)and bevacizumab(BEV 10 mg/kg)...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Héctor Glenn Valdez-López, Alma Iris Cano-Rodríguez, Mario Montemayor-Chapa, Juan Francisco Castillo-Sánchez
BACKGROUND: The prevalence of pleural effusion in Mexico is over 400 per 100 000 inhabitants. The etiology is infectious in 45.7% and neoplastic in 32.6%. Closed pleural biopsy sensibility is 48-70% in cancer and 50-59% in tuberculosis using Cope or Abrams needle. In 1989, Tru-cut needle biopsy was described in a small study for massive pleural effusions with a sensibility of 86%. Our Institute has a wide experience with this infrequently procedure with reliable results than using Cope needle...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
Sandeep S Matreja, Kamal Malukani, Shirish S Nandedkar, Amit V Varma, Anjali Saxena, Arpita Ajmera
INTRODUCTION: Cytological examination of serous effusions helps in staging, prognostication and management of patients with malignancy. The method has disadvantage of lower sensitivity in differentiating reactive atypical mesothelial cells from malignant cells. AIM: The aim of this study is to compare the cytological features of pleural and peritoneal exudative fluids by conventional smear (CS) method and cell block (CB) method and also to assess the utility of a combined approach for cytodiagnosis of these effusions...
October 2017: Nigerian Postgraduate Medical Journal
Sachin S Dole, Gauri P Godbole, Himanshu S Pophale
Background: Medical thoracoscopy has received interest in recent past for diagnostic as well as therapeutic uses. In this study we describe our experience with diagnostic medical thoracoscopy in pleural effusions of undiagnosed etiology. Objectives: 1.To detect diagnostic yield of medical thoracoscopy in pleural effusions of unknown etiology. 2.To find complication rate in these patients. Methodology: In a retrospective analysis of thoracoscopic procedures performed between March 2011 and December 2014, diagnostic yield and complications of thoracoscopic pleural biopsy for achieving a diagnosis in undiagnosed pleural effusions were evaluated...
October 2017: Journal of the Association of Physicians of India
W Chung, Y Jung, K Lee, J Park, S Sheen, K Park
SETTING: A tertiary care academic medical centre. OBJECTIVE: To evaluate the clinical usefulness of C-X-C motif chemokine receptor 3 (CXCR3) ligands in tuberculous pleural effusion (TPE). DESIGN: We recruited 336 patients with pleural effusion due to various causes. Concentrations of interferon-gamma (IFN-γ) and the CXCR3 ligands CXCL9 and CXCL11 were determined using enzyme immunoassays; adenosine deaminase (ADA) activity was measured in pleural fluid and serum...
December 1, 2017: International Journal of Tuberculosis and Lung Disease
Iolanda Godinho, Joana M Dias, Natacha Rodrigues, Hugo Silva, Sofia Jorge, Cristina P Abreu, José A Lopes
Peritoneopleural shunt is an uncommon complication of peritoneal dialysis (PD) usually presenting early as a right pleural transudate. Peritoneopericardial shunt is an even rarer entity in PD, almost never occurring spontaneously. We present the case of a 37-year-old woman on PD for 24 months exhibiting a left pleural and pericardial effusion following pneumonia. Pleural fluid was initially compatible with an exudate with a high glucose concentration and later with a transudate. In order to clarify the suspicion of an ongoing shunt an abdominal scintigraphy was performed confirming the diagnosis of a peritoneopleuropericardial communication...
February 2018: Clinical Nephrology
Ourania S Kotsiou, Panagiota Tzortzi, Rafailia A A Beta, Athanasios Kyritsis, Konstantinos I Gourgoulianis
BACKGROUND: A follow-up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural ADA values across repeated thoracenteses in different types of pleural effusions (PEs) and to evaluate whether ADA variance, in regard to the cutoff value of 40 U/L, affected final diagnosis. METHODS: A total of 131 patients with PEs of various etiologies underwent three repeated thoracenteses. ADA values were subsequently estimated...
December 7, 2017: Journal of Clinical Laboratory Analysis
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
Nanying Che, Yan Ma, Huabin Ruan, Lina Xu, Xueying Wang, Xinting Yang, Xiaohui Liu
BACKGROUND: Tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) are the 2 most frequent causes of exudative pleural effusions (PEs). However, the clinical differentiation is challenging. METHODS: Metabolic signatures in pleural effusion from 156 patients were profiled. An integrated semi-targeted metabolomics platform was incorporated for high throughput metabolite identification and quantitation. In this platform, orbitrap based mass spectrometry with data dependent MS/MS acquisition was applied in the analysis...
February 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
V Riveiro, L Ferreiro, M E Toubes, A Lama, J M Álvarez-Dobaño, L Valdés
BACKGROUND: Myelomatous pleural effusion (MPE) is rare in multiple myeloma, and therefore its characteristics are not well defined. METHODS: A systematic review (4 online databases) was conducted of articles describing the clinical characteristics of patients with MPE, pleural effusion's biochemical characteristics and treatment efficacy. We analysed isolated cases and small retrospective series. RESULTS: We included 98 articles with a total of 153 patients with MPE...
March 2018: Revista Clínica Española
Jasna Radich R, Carlos Álvarez Z, Ana Valenzuela R, Felipe Castillo H, Francisco Moraga V, Jorge Castillo A
Saprochaete capitata (S. capitata) fungal sepsis is a severe condition with a clinical presentation that is similar to other yeast originated fungal sepsis. It is observed in patients with hematological malignancies such as acute myeloid leukemia and neutropenia. We report a 23 year old male presenting with cough, fever and malaise. A bone marrow biopsy led to the diagnosis of acute myeloid leukemia. During the first cycle of chemotherapy the patient presented fever: blood cultures were positive for Klebsiella pneumoniae...
August 2017: Revista Médica de Chile
Merlin Thomas, Wanis H Ibrahim, Tasleem Raza, Kamran Mushtaq, Adeel Arshad, Mushtaq Ahmed, Salma Taha, Saber Al Sarafandi, Hanfa Karim, Hisham A Abdul-Sattar
BACKGROUND: With the exception of areas with high prevalence of tuberculosis, medical thoracoscopy is becoming the diagnostic modality of choice for exudative pleural effusions. The aims of this study were to determine the diagnostic yield and safety of medical thoracoscopy for exudative pleural effusions and ascertain the etiology of such effusions in Qatar. METHODS: This is a retrospective-descriptive study of 407 patients who underwent diagnostic medical thoracoscopy for exudative pleural effusions from January, 2008 till December, 2015 at the only tertiary referral center performing this procedure in Qatar...
November 22, 2017: BMC Pulmonary Medicine
José M Porcel, Lucia Ferreiro, Carme Civit, Luis Valdés, Aureli Esquerda, Richard W Light, Silvia Bielsa
BACKGROUND: Light's criteria misclassify about 30% of cardiac effusions as exudates, possibly leading to unnecessary testing. Our purpose was to derive and validate a scoring model to effectively identify these falsely categorized cardiac effusions, in the setting of natriuretic peptide lacking data. METHODS: We retrospectively analyzed data from 3182 patients with exudative pleural effusions based on Light's criteria, of whom 276 had heart failure (derivation set)...
November 17, 2017: European Journal of Internal Medicine
Mohamad Irani, Alex Robles, Vinay Gunnala, Pak Chung, Zev Rosenwaks
The pathophysiology of isolated pleural effusion in ovarian hyperstimulation syndrome (OHSS) is not well defined. The objective of the current review is to delineate the pathophysiology, risk factors, preventive measures, and therapeutic options of isolated pleural effusion in severe OHSS. Major databases were searched until June 2016. Studies evaluating women who presented with pleural effusion as the sole extra-ovarian manifestation of severe OHSS were included. Data were extracted from 24 articles encompassing 30 reported cases...
October 24, 2017: Gynecological Endocrinology
Y L Chen, J Zhao, R Jia, H Y Wang, J Zheng, C Q Bai, M Z Wang, J M Xu
Objective: To investigate the risk factors, clinical manifestations, radiological features, diagnosis, treatment and prognosis of immune-related pneumonitis caused by programmed death-1(PD-1)/PD-L1 inhibitors. Methods: The clinical data of immune-related pneumonitis caused by PD-1 inhibitor Pembrolizumab in a patient with advanced esophageal carcinoma admitted to the 307(th) Hospital of Chinese People's Liberation Army was retrospectively analyzed and the related literatures were reviewed. We searched Medline database using the keywords"PD-1 inhibitor","PD-L1 inhibitor","Pembrolizumab","Nivolumab","Atezolizumab"combined with"Pneumonitis"by Mar 31, 2017...
October 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
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